Thinking about starting physical therapy? Wondering how to feel more in control of your progress?
There are 3 steps that every single person can take to optimize their physical therapy and help their PT build a truly customized plan of care.
We love to empower our patients to treat their bodies with the same care they would treat their specialized recreational equipment. Your bike needs a tune up? Well, so do you! The truth is that you can be as involved and invested as you want in your healing journey.
To bring it back to the bike metaphor, if you invest the time to learn and practice performing regular maintenance on your bike, you may not need to pay a professional as much as or as often to keep your bike up and running. If you prefer to leave it to the pros, you’ll likely end up paying more and making more trips to the shop to get the same result, but you could be saving yourself the mental burden of managing yet another task. Either approach has merit depending on your preferences - the important thing is that you’re taking whatever steps make the most sense for you to keep that bike in tip-top shape.
While many patients benefit from engaging in a home exercise program and learning the cause of their pain, others might be overwhelmed by or uninterested in the educational aspect. And the homework? Forget about it.
We get it. But that doesn’t mean physical therapy isn’t for you. Physical therapy is for everyone! Each treatment plan is uniquely customized to the patient’s needs - physical, emotional, spiritual, and cultural.
So, how can you make sure to get those needs met? First, make sure you choose a physical therapist who listens to you, understands your goals, and focuses on your purpose not just your pain.
take charge of your care with these 3 tips:
1. KEEP A JOURNAL
Keeping a journal can help the patient and the PT gather valuable information to inform the plan of care. We’ve all been to the doctor and realized halfway to the parking lot that we forgot to ask 50% of our questions, or, worse, forgot to mention a new ache or pain. We’re all human, and it can be difficult to remember the details, especially when we’re under stress (white coat blood pressure is a real thing!).
So, what can you include in a physical therapy journal?
Questions - List out any questions you have. Really. Any questions.
Activity Log - Keep track of the exercises and activities you’ve done between each appointment.
For exercises: list which exercises you did, list how many sets and reps you did, list the weight or resistance you used (and if that changed over time), and list how you felt doing the exercises.Can you feel a muscle contracting and getting fatigued during an exercise or not? Do you experience any pain?Notes - Make sure to note if you feel pain, especially if pain is sudden, sharp, or compounds with additional exercise. Mild pain that doesn’t worsen with additional exercise doesn’t always mean there’s something wrong and could just be part of the strengthening process.
Note when you feel fatigue while performing activity. Make a note if you have a hard time maintaining good form. Does your left knee dip inward when you perform a squat? Write it down. Information like this can be invaluable to your PT and might even be cause to switch up your program.
Unexpected feelings of nausea, lightheadedness, or dizziness are also important to note. And, if you just plain didn’t like doing one of the exercises? Write it down. That’s good info too!
Keeping a journal can provide valuable information to your PT to help tailor your program to your exact needs. Journals are particularly useful in helping your PT recognize patterns that may not become as apparent if we’re only hearing about single snapshots. Sharing some or all of your journal with your PT will help you get the most out of each appointment that you have.
2. DO YOUR HOME EXERCISE PROGRAM
In short, properly-dosed exercise is medicine. Your physical therapist might employ a home exercise program as a form of treatment to help you reach your functional goals, but, just like with any medicine, dosage matters. And, just like with any medicine, some people may need to titrate that dosage to fit their needs. Others may experience unexpected side effects. All of this is a normal part of the process and should be discussed with your PT.
Illustration of a woman exercising at home. Image by Hatice EROL from Pixabay.
If you’re willing and able to perform the “homework” for your physical therapy, you’re likely to experience a faster, positive outcome. Most patients visit their PT 1-2 times per week; however, exercise is almost always more effective when performed at a greater frequency. PTs use home exercise programs to keep that frequency up between visits. Patients who stick with their home exercises more often report a greater satisfaction with their treatment and understanding of their condition.
Your customized home exercise program can act like a regular maintenance manual. Familiarizing yourself with this “manual” can help you learn to prevent re-injury or calm down a flare-up faster.
Remember the bike metaphor? Doing a home exercise program can be more cost-effective. If you use health insurance to pay for PT, there are often co-pays, coinsurance, or visit limits. If you want to get the most out of your visits, it PAYS to do your home exercise program, so that you can see more progress between visits and keep the healing momentum up.
To summarize, a home exercise program can help you get better faster, save $$$, and save time. But if this approach doesn’t feel right for you, that’s okay! We understand that not all HEPs are the same and not all patients find them particularly practical. In fact, up to 70% of patients in the U.S. are not “adherent” to their home exercise program. At least, that’s the language from the linked study. Adherent.
Let’s be clear, if up to 70% of patients aren’t able to adhere to a home exercise program, the problem isn’t with the patient. If you have a new puppy at home, adhering to a floor exercise program might be unexpectedly difficult. If you have a newborn baby at home, setting aside 30 minutes 3 times a day can be daunting. We know that many patients can experience shame over not doing their exercises and that is the LAST THING we want.
We are here to help you heal, not to cause you stress or make you embarrassed. If a program doesn’t work for you FOR WHATEVER REASON, your PT needs to modify your program (even just 15-minutes of exercise can be beneficial when added up over time) or come up with a new approach. And that leads us to the last (and most important) tip - whatever you do, always tell your PT the truth.
3. BE HONEST
Try to be as honest as possible with your physical therapist. Didn’t do the exercises? That’s okay! Let us know! Be honest about how you are feeling. My patients will often say “I don’t know if this is relevant but…” and most of the time it is absolutely relevant. When in doubt, more information is better.
Be honest if you don’t feel like the home exercise program will work for you. Be honest if you don’t feel like you have enough time for your home exercises or treatments. We need the program to work for you, so let us know and we can adapt it. If you show up to a session and you haven’t done your exercises, please don’t feel the need to hide that from your PT. Our job is to hear you and help you, not to judge you.
Communicate with your PT about your care team. Are you seeing a massage therapist, chiropractor, athletic trainers, or naturopath? We wouldn’t want to duplicate interventions between the health and wellness professions. We’d rather focus our attention on our specializations, so if someone is already seeing a chiropractor for the same condition, we’ll redirect our approach away from the spine.
If you are already seeing a massage therapist, we may want to reduce manual therapy for our appointment. Too much massage dramatically increases the soreness compared to the benefit (return on investment can decrease with excessive massage), so we wouldn’t want to focus too hard on that treatment approach.
If you experience a mental block about an exercise, find yourself apprehensive to do an exercise, or it’s just not working for you, make a note of it and share that info with your PT. Level with us.
If there’s an exercise that makes you uncomfortable for a personal, cultural, spiritual, or ANY other reason, let us know. If glute bridges or clamshell exercises are an uncomfortable movement for you for ANY reason, let’s talk about it. No shame. No judgement.
We’re here to help you succeed. Your care deserves to be customized to your needs. If you can’t or won’t do the exercise, we need to scrap it in favor of something that works for you.
We hope these tips make you feel a little more empowered in your journey to feel and move your best. If you’re ready to get started on your custom care plan, book your free new client consultation on our website or send us an email/DM.
